Healthcare Provider Details

I. General information

NPI: 1326206848
Provider Name (Legal Business Name): SON X NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23451 MADISON ST SUITE 340
TORRANCE CA
90505-4763
US

IV. Provider business mailing address

23451 MADISON ST SUITE 340
TORRANCE CA
90505-4763
US

V. Phone/Fax

Practice location:
  • Phone: 310-373-6864
  • Fax: 310-373-9547
Mailing address:
  • Phone: 310-373-6864
  • Fax: 310-373-9547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD431836
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: